Abstract 468: Diversity of Apolipoprotein E genetic polymorphism significance on cardiovascular risk is determined by the presence of Metabolic Syndrome among hypertensive patients

Abstract

INTRODUCTION: Hypertension has a significant relevance as a cardiovascular risk factor. A consistent increase on world’s Metabolic syndrome (MetS) incidence has been associated with an epidemic cardiovascular risk in different populations. Dislipidemia plays a major role determining the epidemic CV burden attributed to MetS. Apolipoprotein E (ApoE) is involved on cholesterol and triglycerides metabolism regulation. Once ApoE polymorphism may influence lipid metabolism, it is possible that it brings on individual susceptibility consequences for the development of MetS and cardiovascular risk. OBJECTIVE: To measure the discriminatory power of ApoE polymorphism in determining the cardiovascular risk stratification based on the presence MetS in a cohort of hypertensive patients. PATIENTS AND METHODS: It was enrolled 401 patients, divided in two groups, classified by MetS presence (IDF criteria): Group 1: 275 patients with MetS (MetS +) and Group 2: 126 patients without Mets (MetS -). Patient’s data were collected by clinical evaluation, physical exam, file reviews and laboratory testing. Polymorphic ApoE analysis was performed by PCR amplification. Groups were compared on clinical and laboratorial characteristics as well as allele and genotype distribution in relation to ApoE polymorphism. Prevalence of CVD, in relation to Mets presence, was analysed based on allele 4 prevalence. RESULTS: The results evidenced 186 men (47,4%), 62,1% whites, 44,1% diabetics and 11,5% of patients were smokers. Mean age was 64,0±12,0 years. When genotypic distribution was analyzed, E3/3 genotype and E3 allele frequency were more prevalent. Among patients with MetS, we observed an independent association between CVD prevalence and allele E4 frequency(OR 2.42(1.17-1.5, p<0,05)). On the contrary, in those without MetS, there was lesser CVD burden in E4 allele carriers(OR 0,14(0,02-0,75)). These associations remained significant even after confounding factor corrections. CONCLUSION: The results presented show that association between ApoE gene and CVD maybe modulated by de presence of MetS, with an increased CV burden observed among E4 carriers with the Syndrome. On the opposite way, E4 carriers without visceral obesity had a lesser prevalence of CVD.